Discharge and termination letters

Discharge and termination letters are formal notices that end care. Owners and admins manage the clinic-wide wording by clicking Settings in the left sidebar, then clicking Discharge Letters under Configuration. A patient letter opens from the patient's chart and uses those settings as its starting point.

How do I set up discharge and termination letter defaults?

In the left sidebar, click Settings (at the bottom). In the settings menu, under Configuration, click Discharge Letters to control the parts of the letter your clinic can edit. These settings apply to letters signed from now on; they do not change letters that are already signed.

1. In the left sidebar, click Settings (at the bottom). In the settings menu, under Configuration, click Discharge Letters.
2. In Wording, enter Service name if the heading should name the type of care your practice provides.
3. Set Grace period. This controls how long emergency care and refills continue, and sets the default effective date on new letters.
4. Enter Records request phone if patients should call a specific number for records.
5. In Contents, turn Current prescriptions on if the letter should print active medications from the chart.
6. In Closing text, update Emergency support and Closing paragraph if your clinic needs custom language.
7. Select Save.

The page shows Discharge letters updated. Letters signed from now on use the saved settings.

How do I choose the reasons clinicians can select?

In the left sidebar, click Settings (at the bottom). In the settings menu, under Configuration, click Discharge Letters to decide which reasons appear when someone writes a discharge or termination letter. If you select no reasons, the full list is offered.

1. In the left sidebar, click Settings (at the bottom). In the settings menu, under Configuration, click Discharge Letters.
2. Find Reasons offered.
3. Check each reason clinicians should be able to choose.
4. Select Offer all if you want to clear your selections and make the full list available again.
5. Select Save.

When a clinician writes a letter, only reasons that match the letter type appear. Switching between Termination and Discharge removes any selected reasons that do not apply to the new type.

How do I add continuity-of-care resources?

In the left sidebar, click Settings (at the bottom). In the settings menu, under Configuration, click Discharge Letters to add organizations or websites that help patients find another provider. These resources print in the letter.

1. In the left sidebar, click Settings (at the bottom). In the settings menu, under Configuration, click Discharge Letters.
2. In Continuity of care, select Add resource.
3. Enter the resource name.
4. Add a link if you want one printed with the resource.
5. Select Add resource again for additional entries.
6. Select Save.

If there are no resources, the letter asks patients to find a new provider without listing specific organizations.

How do I write a discharge or termination letter for a patient?

In the left sidebar, click Patients, then click the patient's name. In the patient chart footer, select Export, then select Discharge letter…. A draft starts when the sheet opens. If the patient already has an open draft, the sheet reuses it instead of creating another one.

1. Under Letter, choose Termination when the practice is ending the relationship, or Discharge when care has concluded.
2. Set Date of letter and Effective date. Care continues until the effective date.
3. Under Reasons for termination or Reasons for discharge, select at least one reason. Only selected reasons print.
4. Review Current prescriptions if that section is turned on. The list comes from the chart and is not edited in the letter.
5. In Printed details, review the patient's address and the provider's Provider, Credentials and NPI. Changes here apply to this letter only.
6. Add an Additional paragraph if this letter needs patient-specific wording.

The draft saves when you preview or generate the letter. You cannot generate a letter until at least one reason is selected.

How do I preview and sign a letter?

Use Preview before signing when you want to read the generated PDF at full page size. Signing stores the PDF on the patient's chart and freezes the letter.

1. In the left sidebar, click Patients, then click the patient's name. In the patient chart footer, select Export, then select Discharge letter….
2. In the discharge letter sheet, select Preview.
3. Review the PDF that opens in a new tab.
4. Return to the letter sheet and make any needed edits.
5. Select Generate and sign.
6. In Sign the discharge letter, draw your signature, or leave it blank to sign with the signature saved on your profile.
7. Select the signing button. It reads Sign with drawn signature after you draw, or Sign letter if you leave the pad blank.

The page shows Letter signed. The signed PDF is stored on the patient's chart, and the letter becomes read-only.

How do I issue a letter for hand signature?

Issue an unsigned letter when it needs to be printed and signed by hand. This is final in the same way as an electronically signed letter: the letter becomes read-only, and you must void it to replace it.

1. In the left sidebar, click Patients, then click the patient's name. In the patient chart footer, select Export, then select Discharge letter….
2. Complete the letter details and select at least one reason.
3. Choose the option to issue the letter for hand signature.

After you issue it, the page shows Letter generated. Print it and sign by hand. The PDF is stored on the patient's chart.

How do I download or fax a final letter?

In the left sidebar, click Patients, then click the patient's name. In the patient chart footer, select Export, then select Discharge letter….

A letter can be shared only after it is signed or issued for hand signature. Drafts and voided letters cannot be downloaded or faxed from the share control.

1. Open a signed or issued letter.
2. Use the share control on the final letter to download the stored PDF.
3. If faxing is enabled for your organization, use the share control to prepare the PDF for faxing.

If the fax attachment cannot be sent, the page tells you before opening the fax dialog.

How do I correct a signed or issued letter?

Signed and issued letters are frozen. To correct one, void it and start a new letter.

1. In the left sidebar, click Patients, then click the patient's name. In the patient chart footer, select Export, then select Discharge letter….
2. Choose the option to void the letter.
3. Enter a reason if you want it recorded.
4. Confirm the void.
5. Start a new letter for the patient.

The page shows Letter voided. The signed copy stays on the chart as a record, and the replacement letter starts as a new draft.

What can't I do here?

Discharge and termination letters have these limits:

• Clinicians can write patient letters, but only owners and admins can manage discharge letter settings by clicking Settings in the left sidebar, then clicking Discharge Letters under Configuration.
• You cannot generate a letter until at least one reason is selected.
• You cannot edit a signed, issued or voided letter.
• You cannot share a draft letter. Finalize it first by signing it or issuing it for hand signature.
• You cannot share a voided letter from the share control.
• You cannot edit Current prescriptions in the letter. Update medications on the chart instead.
• Settings changes apply to letters signed from now on. They do not rewrite letters already signed.

Common questions

What is the difference between Termination and Discharge?

Choose Termination when the practice is ending the relationship. Choose Discharge when care has concluded, such as goals met or care transferred. The available reasons change based on the type.

What does the grace period do?

Grace period controls how long emergency care and refills continue. It also sets the default Effective date on new letters. Required notice varies by state.

Can an office manager sign for a provider?

The letter records the signer separately from the provider details printed on the letter. Owners, admins and clinicians can sign discharge letters.

What happens if the patient has no active medications?

If Current prescriptions is turned on and there are no active medications, the letter prints that there are no active prescriptions on record.

How do I update my NPI before sending letters?

You can edit the NPI in Printed details for one letter. To update your saved provider details, see Your NPI and individual insurance details.